HomeMy WebLinkAboutInspection Docs, req for 30 day temp power release form 12-10-'20 15:39 FROM- 7728787656 T-821 P0001/0010 F-048
an
Requ `fort Sty'-Of `T,emoi3i*ry:Pd r-Relet"
Dam- � ����t- - r 14"ber.,
1ect Address:
THE UNDERSIGNED HST—BY REQLkST RELEASE OF ElEC cAL POWER TO 7HE ABOVE DES+CiMED
PROPERTY, FOR A PWOD NOT TO EXCEED TRMTY.(30) DAYS,FOR THE PURPOSE OFTES-MG SYSTEMS
AND EQUIPMENT IN PREP, ZA710N FOR A-F-ML.INS(? ON. 'IN CONSI tMON OF APPROVAL OF THE
ABQL WE•13EI&BY ACRq0WLW.t;E-AND AdtEASFOLLO S:
I. rarY Power rdease is rquested for the abovi-s gated puMma only,and t we'wig be no
ac[upancY of anY type,ogler than that pttrtiAted tv tmnsltuc ton timdng Wis time period,
2. As'witriness by our signat�rw we.herby agree tp:abid!t by•aH terms and a0riditions of t Ns agmernerk
!ncludiro Buildtnt Ditrls'son Policy;which is iricorQaeatsd herein by reference.
3. All condiitibm and re4uireinents listed ire the e0ched document entrded"Rewrame&for 3o Day
Pawar for`resting'".haueeen b fulfilled and the preraise is ready for compi'fance,lrrpecdon.
4. All requests for ah,tension biWond 30 daA mt*'t be,.mrade in writing t•o the Wilding Offiaat stating
the reason` br the regfuest. Power MaY be rem.6Ved fiord the site.and/or a Stop 1111,ork.Order issued•lf
the Rhal Inspection hat riot beery approved within 30 days. A fee of$100.60 wiii be regihred to lift
the Stop Work Order.
WE HEREBY RELEASE-AND AGREE TO BOLD.HARMLESS,ST, LUCIE G`OUNTY,AND THE R EMPLOYEES FROM
ALL t�AR11TIES AND aAIMS OF ANY TYPE OJ l�lAiUR`E"W' ItH KAY ARISE NOW OR IN THE FUTURE OUT
OFTEN TRANSAC,TlQN,INCLUDING AN �AMACE �I NIfIY SE RED WE T07HE
DISCON C-CmN Of.
.Pal; Tt tir£ti►�� �O[ ON OF T;-IIS�IGR�£Nli
Ow 1GSNMA Qa
�r-- �A
cortti + oiz DATE
ELECFRICAL CONTRAC11OR SIGN1ITORE . WE'